The Effect of Religious Dietary Cultures on Food Nitrogen and Phosphorus Footprints: A Case Study of India.

The excessive consumption of nitrogen (N) and phosphorus (P), two vital nutrients for living organisms, is associated with negative environmental and health impacts. While food production contributes to a large amount of N and P loss to the environment, very little N and P is consumed as food. Food habits are affected by multiple regulations, including the dietary restrictions and dictates of various religions. In this study, religion-sensitive N-Calculator and P-Calculator approaches were used to determine the impact of religious dietary culture on the food N and P footprints of India in the major religious communities. Using 2013 data, the food N footprint of Hindus, Muslims, Christians, and Buddhists was 10.70, 11.45, 11.47, and 7.39 kg-N capita-1 year-1 (10.82 kg-N capita-1 year-1 was the national average), and the food P footprint was 1.46, 1.58, 1.04. and 1.58 kg-P capita-1 year-1 (1.48 kg-P capita-1 year-1 was the national average). The findings highlight the impact of individual choice on the N and P food footprints, and the importance of encouraging the followers of religion to follow a diet consistent with the food culture of that religion. The results of this study are a clear indication of the requirement for religion-sensitive analyses in the collecting of data pertinent to a particular country for use in making government policies designed to improve the recycling of food waste and the treatment of wastewater.

Interactive Web-based Data Visualization and Analysis Tool for Synthetizing on-farm Research Networks Data.

The on-farm research network concept enables a group of farmers to test new agricultural management practices under local conditions with support from local researchers or agronomists. Different on-farm trials based on the same experimental design are conducted over several years and sites to test the effectiveness of different innovative management practices aimed at increasing crop productivity and profitability. As a larger amount of historical trial data are being accumulated, data of all the trials require analyses and summarization. Summaries of on-farm trials are usually presented to farmers as individual field reports, which are not optimal for the dissemination of results and decision making. A more practical communication method is needed to enhance result communication and decision making. R Shiny is a new rapidly developing technology for turning R data analyses into interactive web applications. For the first time for on-farm research networks, we developed and launched an interactive web tool called ISOFAST using R Shiny. ISOFAST simultaneously reports all trial results about the same management practice to simplify interpretation of multi-site and multi-year summaries. We used a random-effects model to synthetize treatment differences at both the individual trial and network levels and generate new knowledge for farmers and agronomists. The friendly interface enables users to explore trial summaries, access model outputs, and perform economic analysis at their fingertips. This paper describes a case-study to illustrate how to use the tool and make agronomic management decisions based on the on-farm trial data. We also provided technical details and guidance for developing a similar interactive visualization tool customized for on-farm research network. ISOFAST is currently available at https://analytics.iasoybeans.com/cool-apps/ISOFAST/.

Agronomic and Economic Interactions between Sidedressed Nitrogen and Potassium Fertilizations on Atlantic Potato

Abstract Nitrogen (N) and potassium (K) in potato crop planting synergistically increase tuber yield, but there are no studies on this interaction in sidedressing. In two experiments with 'Atlantic' potato combinations of four N rates (0, 50, 100, and 150 kg ha-1) with four K2O rates (0, 100, 200, and 300 kg ha-1) were applied in sidedressing in a 4×4 factorial scheme with three replications in a completely randomized design. Adjacent commercial fields were sampled to economic comparisons with experimental results. Significant interaction between N and K sidedressing rates with tuber yields increase also was confirmed and classified as Liebig-synergism. Compared to the isolated N and K applications in sidedressing, joint N and K fertilizations, respectively, increases by 11% and 48% marketable tuber yields in the summer-fall experiment, and 12% and 7% in the spring experiment. Joint N and K applications as sidedressing was more profitable than planting fertilization, mainly at higher N and K rates. The response of specific gravity of 'Atlantic' potato tubers to the N and K sidedressing rates was mediated by interactions between edaphoclimatic conditions and inputs of N and K. The combined application of N and K sidedressing rates increased specific gravity in the summer-fall experiment, but had a negative effect in the spring experiment. Therefore, our results provide strong evidence that the fertilization management for potato crop in Brazil can be modified by applying higher amounts of N and K in sidedressing to match nutritional needs of the crop.

Using morphological attributes for the fast assessment of nutritional responses of Buddhist pine (Podocarpus macrophyllus [Thunb.] D. Don) seedlings to exponential fertilization.

Culturing slowly growing tree seedlings is a potential approach for managing the conflict between the increasing demand for ornamental stock and the decreasing area of farmlands due to urbanization. In this study, Buddhist pine (Podocarpus macrophyllus [Thunb.] D. Don) seedlings were raised in multishelves with light-emitting diode lighting in the spectrum of 17:75:8 (red:green:blue) at 190-320 µmol m-2 s-1 with controlled temperature and relative humidity at 19.5°C and 60%, respectively. Seedlings were fed by exponential fertilization (EF) (nitrogen [N]-phosphorus [P]2O5-K2O, 10-7-9) at eight rates of 0 (control), 20 (E20), 40 (E40), 60 (E60), 80 (E80), 100 (E100), 120 (E120), and 140 (E140) mg N seedling-1 for four months through 16 fertilizer applications. The nutritional responses of Buddhist pine seedlings can be identified and classified into various stages in response to increasing doses, up to and over 120 N seedling-1. Morphological traits, i.e., the green color index and leaf area (LA) obtained by digital analysis and the fine root growth, all remained constant in response to doses that induced steady nutrient loading. LA had a positive relationship with most of the nutritional parameters. A dose range between 60 and 120 mg N seedling-1 was recommended for the culture of Buddhist pine seedlings. At this range of fertilizer doses, measuring the leaf area through digital scanning can easily and rapidly indicate the inherent nutrient status of the seedlings.

Estimating the energetic cost of feeding excess dietary nitrogen to dairy cows.

Feeding N in excess of requirement could require the use of additional energy to metabolize excess protein, and to synthesize and excrete urea; however, the amount and fate of this energy is unknown. Little progress has been made on this topic in recent decades, so an extension of work published in 1970 was conducted to quantify the effect of excess N on ruminant energetics. In part 1 of this study, the results of previous work were replicated using a simple linear regression to estimate the effect of excess N on energy balance. In part 2, mixed model methodology and a larger data set were used to improve upon the previously reported linear regression methods. In part 3, heat production, retained energy, and milk energy replaced the composite energy balance variable previously proposed as the dependent variable to narrow the effect of excess N. In addition, rumen degradable and undegradable protein intakes were estimated using table values and included as covariates in part 3. Excess N had opposite and approximately equal effects on heat production (+4.1 to +7.6 kcal/g of excess N) and retained energy (-4.2 to -6.6 kcal/g of excess N) but had a larger negative effect on milk gross energy (-52 to -68 kcal/g of excess N). The results suggest that feeding excess N increases heat production, but more investigation is required to determine why excess N has such a large effect on milk gross energy production.

Assessment of unconsciousness in pigs during exposure to nitrogen and carbon dioxide mixtures.

The aim of this study was to assess unconsciousness in pigs during and after the exposure to gas mixtures of 70% nitrogen (N(2)) and 30% carbon dioxide (CO(2)) (70N30C), 80% N(2) and 20% CO(2) (80N20C) and 85% N(2) and 15% CO(2) (85N15C) compared with 90% CO(2) in air (90C) by means of the Index of Consciousness(®)(IoC), their behaviour and the absence of brain stem reflexes. The experiment included three trials of 24 pigs divided into four groups according to the number of treatments. Half of the group was exposed for a short time and the other half for a long time (3 and 5 min for the N(2)/CO(2) mixtures exposure and 2 and 3 min in 90C exposure, respectively). During exposure, the IoC and the electroencephalography suppression rate (ESR) were assessed, as well as the time to onset and percentage of gasping, loss of balance, vocalizations, muscular excitation and gagging. At the end of the exposure, the corneal reflex, rhythmic breathing and sensitivity to pain were each assessed at 10 s intervals for 5 min. Brain activity decreased significantly (P < 0.05) 37.60 s after the start of the exposure to 90% CO(2), which was significantly earlier than in 70N30C, 80N20C and 85N15C exposure, (45.18 s, 46.92 s and 43.27 s, respectively). Before brain activity decreased, all pigs experienced gasping and loss of balance and a 98% muscular excitation. The duration of the muscular excitation was longer in animals exposed to 70N30C, 80N20C and 85N15C than 90C (P < 0.01). After a long exposure time, all animals exposed to 90C died, whereas the 30.4% of animals exposed to N(2)/CO(2) gas mixtures survived. Pigs exposed to 85N15C recovered corneal reflex and sensitivity to pain significantly earlier than when exposed to 90C. Exposure to 90C causes a higher aversive reaction but a quicker loss of consciousness than N(2)/CO(2) gas mixtures. Exposure to N(2)/CO(2) gas mixtures causes a lower percentage of deaths and an earlier recovery of the brain stem activity than 90C, whereas the time to recover the cortical activity is similar. In conclusion, the inhalation of N(2)/CO(2) gas mixtures reduces the aversion compared with high concentrations of CO(2); however, the period of exposure for inducing unconsciousness may be longer in N(2)/CO(2) gas mixtures, and the signs of recovery appear earlier, compared to CO(2).

Lower risk of decompression sickness after recommendation of conservative decompression practices in divers with and without vascular right-to-left shunt.

INTRODUCTION: A vascular right-to-left shunt (r/l shunt) is a well-known risk factor for the development of decompression sickness (DCS). No studies to date have examined whether divers with a history of DCS with or without a r/l shunt have a reduced risk of suffering recurrent DCS when diving more conservative dive profiles (CDP). METHODS: Twenty-seven divers with a history of DCS recommended previously to dive more conservatively were included in this study and retrospectively interviewed by phone to determine the incidence of DCS recurrence. RESULTS: Twenty-seven divers performed 17,851 dives before examination in our department and 9,236 after recommendations for conservative diving. Mean follow up was 5.3 years (range 0-11 years). Thirty-eight events of DCS occurred in total, 34 before and four after recommendation of CDP. Four divers had a closure of their patent foramen ovale (PFO). A highly significant reduction of DCS risk was observed after recommendation of CDP for the whole group as well as for the sub-groups with or without a r/l shunt. A significant reduction of DCS risk in respect to r/l shunt size was also observed. DISCUSSION: This study indicates that recommendations to reduce nitrogen load after DCS appear to reduce the risk of developing subsequent DCS. This finding is independent of whether the divers have a r/l shunt or of shunt size. The risk of suffering recurrent DCS after recommendation for CDP is less than or equal to an unselected cohort of divers. CONCLUSION: Recommendation for CDP seems to significantly reduce the risk of recurrent DCS.

Assessment of cryotherapy by liquid nitrogen in the treatment of hand and feet warts.

BACKGROUND: Cryotherapy with liquid nitrogen is the most widely used method to treat hand and feet warts. Therapeutic response to this method depends on many factors related to warts and to the patient. The aim of this study is to determine factors influencing therapeutic response of warts to cryotherapy by liquid nitrogen. METHODS: It was a prospective transversal study including 100 patients with warts of the hands and/or feet treated by cryotherapy with liquid nitrogen (cotton wool bud) and referred to Dermatology Department of Charles Nicolle Hospital of Tunis. Demographic data, so as characteristics of warts were recorded. Patients received one treatment/week with a maximum of 4 sessions. Patients whose warts were seen to be resolved were classified as cured. Cure-predictive factors were studied with a multi varied study with logistic regression. RESULTS: Of the 100 patients (56 females/44 males, Mean age: 22 years), ten were withdrawn. In 89 patients, warts were present on hands, whereas 23 had warts on feet and 12 had warts on both hands and feet. The mean number of warts per patient was 7. The total cure rate was of 64.4% and was more elevated in hands compared to feet (70.8% versus 10.5%). There was no difference between mean ages of cured group and not cured one (22.2 years versus 21 years). The mean duration of warts in cured patients was lower than that of not cured patients. The mean number of warts before treatment was 4.3 in cured patients and 12.3 warts in not cured patients. The mean number of treatments was 2.3 in cured patients and 4 treatments in not cured patients. The difference between these factors into cured and not cured groups was statistically significant in uni-varied study but not significant in multi-varied one. CONCLUSION: The effectiveness of liquid nitrogen used by traditional method in the treatment of hand and feet warts seems to depend on multiple factors: wart's duration, number of warts and number of treatments. These factors depend on each other.

Economically optimal nitrogen rate reduces soil residual nitrate.

Post-harvest residual soil NO(3)-N (RSN) is susceptible to transfer to water resources. Practices that minimize RSN levels can reduce N loss to the environment. Our objectives were (i) to determine if the RSN after corn (Zea mays L.) harvest can be reduced if N fertilizer is applied at the economically optimal N rate (EONR) as compared to current producer practices in the midwestern USA and (ii) to compare RSN levels for N fertilizer rates below, at, and above the EONR. Six experiments were conducted in producer fields in three major soil areas (Mississippi Delta alluvial, deep loess, claypan) in Missouri over 2 yr. Predominant soil great groups were Albaqualfs, Argiudolls, Haplaquolls, and Fluvaquents. At four transects in each field, six treatment N rates from 0 to 280 kg N ha(-1) were applied, the EONR was determined, and the RSN was measured to a 0.9-m depth from five treatment plots. The EONR at sampling sites varied from 49 to 228 kg N ha(-1) depending on site and year. Estimated average RSN at the EONR was 33 kg N ha(-1) in the 0.9-m profile. This was at least 12 kg N ha(-1) lower than RSN at the producers' N rates. The RSN increased with increasing Delta EONR (total N applied - EONR). This relationship was best modeled by a plateau-linear function, with a low RSN plateau at N rates well below the EONR. A linear increase in RSN began anywhere from 65 kg N ha(-1) below the EONR to 20 kg N ha(-1) above the EONR at the three sites with good data resolution near the EONR. Applying N rates in excess of the EONR produced elevated RSN values in all six experiments. Our results suggest that applying the EONR will produce environmental benefits in an economically sound manner, and that continued attempts to develop methods for accurately predicting EONR are justified.

Quantitative assessment of regional alveolar ventilation and gas volume using 13N-N2 washout and PET.

UNLABELLED: Measurement of alveolar volume (Va) and regional ventilation (a) is crucial to understanding the pathophysiology of acute lung injury and ventilator-induced lung injury. PET has previously been used as a noninvasive, quantitative method to assess a, but formal validation of this technique in experimental lung injury is lacking. This study aims to validate Va and a regional assessment with PET, using inhaled (13)N-N(2) in pigs. METHODS: Two normal and 2 oleic acid-injured pigs were tracheotomized, mechanically ventilated, and studied in 5 different levels of ventilation by changing respiratory rate. In each experimental condition, lungs were washed-in and then washed-out with (13)N-N(2) through an open circuit in the ventilator. Using this method, multiframe images were acquired with a dedicated PET camera. Regions of interest (ROIs) were drawn on each lung. Regional time-activity curves during washout were generated for each ROI and fitted to a mono- and a bicompartmental model. Validation of this method was performed in 2 ways. First, regional values of predicted Va (Va(emission)) were compared with regional volume obtained independently from density analysis on a transmission scan (Va(trans)). Second, regional values of predicted a were summed in each animal during each experimental condition and compared with minute-ventilation values set on the ventilator. RESULTS: The bicompartmental model best fitted the experimental values in normal (94.7% [62.2%-100.0%] (median [interquartile range]) of the ROIs) as well as in injured animals (90.7% [81.6%-97.4%] of the ROIs) (P = 0.49). Va(emission) significantly correlated with Va(trans) (R(2) = 0.89, P < 0.001) but exceeded Va(trans) by 10%. Finally, a strongly and positively correlated with minute-ventilation in both normal (R(2) = 0.96, P < 0.001) and injured (R(2) = 0.96, P < 0.001) animals. CONCLUSION: Measurement of (13)N-N(2) washout using PET is accurate to assess regional alveolar volume and ventilation during experimental acute lung injury.

Ileal losses of nitrogen and amino acids in humans and their importance to the assessment of amino acid requirements.

BACKGROUND & AIMS: Irreversible amino acid losses at the human ileum are not taken into account when tracer-derived amino acid requirements are calculated because the data available are scarce. We have investigated amino acid losses at the ileal level in humans after ingestion of a protein meal. METHODS: Thirteen volunteers ingested a single meal of 15N milk or soy proteins. The appearance of 15N and 15N amino acids in the ileal effluents collected using an ileal tube was monitored for 8 hours. RESULTS: In the soy group, higher losses of endogenous nitrogen, especially originating from amino acids, were observed, as well as a higher flow rate of dietary non-amino acid nitrogen. With soy protein, the digestibilities of valine, threonine, histidine, tyrosine, alanine, and proline were significantly lower than with milk. Ileal losses of leucine, valine, and isoleucine amounted to 12, 10, and 7 mg x kg(-1) x day(-1), respectively. Threonine ileal loss (9-12 mg x kg(-1) x day(-1)) was particularly high compared with the current amino acid requirement. CONCLUSIONS: Amino acid losses at the human terminal ileum are substantial and depend on the type of dietary protein ingested. Although it remains unclear whether intact amino acids are absorbed in the colon, we suggest that ileal losses should be considered an important component of amino acid requirements.

Biased over- or under-reporting is characteristic of individuals whether over time or by different assessment methods.

Seven studies with repeated measurements of energy intake and/or nitrogen intake were examined to determine whether misreporting is characteristic of some persons or occurs randomly. Four of the studies were validated by doubly labeled water measurements of energy expenditure. Reporting validity was expressed as the ratio of energy intake to energy expenditure. Ratios were consistently below the expected value of 1.0 for some subjects and consistently above 1.0 for others, indicating characteristic reporting validity within subjects. Two year-long studies provided 4 to 12 measurements and a total number of days sufficient to measure individual habitual intake. Subjects mean energy intake to basal metabolic rate (BMR) ratios were < 1.35 in 45% and 47% and < 1.35 at every measurement in 25% of subjects. This indicated persistent underreporting over time, because 1.35 x BMR is the minimum energy expenditure compatible with a normally active lifestyle. Three of the studies used more than 1 assessment method (validated by doubly labeled water and/or urinary nitrogen excretion). There was a tendency for persons determined to be underreporters by 1 method to be also underreporters when tested by other methods. We conclude that biased over- or underreporting is characteristic of some persons. Thus, repeat measurements do not necessarily provide valid measures of individual intake, extreme intakes may reflect under- and overreporting rather than true low or high intakes, and subjects most prone to reporting bias may be repeatedly misclassified in quantiles of the distribution. This presents a challenge to dietitians nutritionists, and statisticians both for the design of surveys and the handling of flawed data.

Validation of dietary intakes measured by diet history against 24 h urinary nitrogen excretion and energy expenditure measured by the doubly-labelled water method in middle-aged women.

A diet history method for estimating energy and N intakes was validated against 24 h urinary N excretion and energy expenditure measured by the doubly-labelled water (DLW) method. Forty-eight women aged 50-65 years were studied over 1 year. Weighed diet records from 4 d and two 24 h urine collections, for measurement of urinary N excretion, were obtained in each of four seasons. At the end of the year, a diet history was obtained, BMR was measured by whole-body calorimetry, and, in sixteen women, total energy expenditure (EE) was measured by DLW. Energy intake (EI) and N intake (NI) were calculated using food tables. Using weighed records and diet history respectively mean NI were 11.21 (SD 2.09) g and 11.47 (SD 2.40) g (NS) and EI were 8.08 (SD 1.54) MJ and 8.20 (SD 1.86) MJ (NS). Mean urine N:NI and EI:BMR values indicated bias to under-reporting by weighed record and diet history techniques in some individuals, but there was no significant difference between these measures at the group level. The Pearson correlation coefficient (r) for urine N v. NI was 0.81 for the weighed record and 0.38 for the diet history. The correlation of EE v. EI was r 0.48 for weighed record and r 0.11 for diet history. In this study the diet history gave the same estimate of mean intake, but the weighed record appeared to perform better in ranking individuals.

Air contamination of a closed anesthesia circuit.

Closed-circuit anesthesia (CCA) has certain advantages such as decreased cost, decreased anesthetic gas pollution, improved inhalational gas humidity and temperature in comparison to conventional inhalational anesthesia using a high fresh gas flow, i.e. more than 2 L x min(-1), with a semi-closed breathing circuit. The main disadvantage of CCA is the possibility of hypoxic anesthetic gas delivery. This potentially lethal situation is caused by an insufficient oxygen flow rate for the body metabolism or by the accumulation of inactive gas, usually nitrogen, within the breathing circuit in spite of a sufficient oxygen concentration in the fresh gas supply to the breathing circuit. In the latter case, the accumulation of inactive gas may also lead an increased risk of awareness because of its dilution effect on the concentrations of inhalational anesthetics. We herein present a case of air contamination of the breathing circuit through a sampling line of an anesthetic gas monitor. The air caused a decrease in the oxygen concentration during closed circuit anesthesia.

Validation of dietary intakes of protein and energy against 24 hour urinary N and DLW energy expenditure in middle-aged women, retired men and post-obese subjects: comparisons with validation against presumed energy requirements.

OBJECTIVES: To compare validation of reported dietary intakes from weighed records against urinary nitrogen excretion and energy expenditure measured by DLW, and to examine the utility of the Goldberg cut-off for EI:BMR in the identification of under-reporters. DESIGN: Energy (EI) and nitrogen (protein) intake (NI) were measured by 16 d of weighed diet records collected over 1 y. They were validated against urinary nitrogen excretion in 5-8 (mean 6.0) 24 h urine collections and total energy expenditure (EE) measured by doubly labelled water (DLW). Basal metabolic rate (BMR) as measured by whole body calorimetry in women or bedside ventilated hood (Deltatrac) in men. Individual subjects were identified as under-reporters if Urine N:NI was > 1.00 or if EI:EE was < 0.79. The agreement between the two ratios in detecting under-reporting was examined. The results from the direct validation by DLW were also compared with validation using the Goldberg cut-off for EI:BMR (Goldberg et al, 1991). SUBJECTS: Eighteen women aged 50-65 y and 27 men aged 55-87 y were selected from participants in two larger dietary surveys as representing the full range of dietary reporting as measured by Urine N:NI. Data from a previous study of 11 post-obese subjects were also included. RESULTS: The two ratios, Urine N:NI and EI:EE, were significantly related (r = -0.48, P < 0.01). Using the above cut-offs, seven (4F, 3M) subjects were identified as under-reporters by both methods, one (1M) by Urine N:NI only and 8 (3F, 5M) by EI:EE only. There was close agreement in post-obese subjects where 6 subjects showed a substantial degree of under-reporting by both methods (r = -0.87, P < 0.001). The correlation between direct validation by DLW and EI:BMRest was 0.65 (P < 0.001). Some limitations of the Goldberg cut-off for identifying individual under-reporters were demonstrated. CONCLUSIONS: EI:EE provides an estimate of the degree of under-reporting of energy at the group and individual level. Urine N:NI identifies under-reporting of protein intake and the most obvious under-reporters of energy, but is probably of lesser value in estimating the overall degree of under-reporting of energy at group level. Good validation by EI:BMR depends on knowledge of physical activity at both group and individual level. However, the correlation of 0.65 between EI:EE and EI:BMRest suggests that EI:BMR could be usefully incorporated into analysis of data from epidemiological studies. Validation measures consisting of at least predicted EI:BMR ratios and urinary measures should be incorporated into dietary surveys. SPONSORSHIP: This work was funded by the Ministry of Agriculture Fisheries and Food, the Medical Research Council, the Cancer Research Council and the Swedish Medical Research Council and the Henning and Johan Throne-Holst Foundation.

Using biochemical markers to assess the validity of prospective dietary assessment methods and the effect of energy adjustment.

The validity of dietary assessment methods in a group of women aged 50-65 y was evaluated with use of biochemical markers. Estimates of nitrogen, potassium, and carotene intakes from weighed-food and estimated records yielded higher correlations with urinary nitrogen, urinary potassium, and serum concentrations of carotenoids than did estimates from food-frequency questionnaires and 24-h recalls. When the residuals method of energy adjustment was used, the correlations between intakes of nitrogen and potassium estimated from food-frequency questionnaires and 24-h recalls and intakes derived from weighed-food records improved, and the high correlations between biochemical markers and estimates from weighed-food records were maintained. In addition, with use of this method, estimates for nitrogen and potassium intakes from food-frequency questionnaires showed the most improvement in comparison with the biochemical markers; however, the correlations of crude nitrogen and potassium with crude energy intake were highest. Carotene intake was not related to energy intake, so that correlations between the intake of carotene assessed by any method and the plasma beta-carotene concentration did not improve with energy adjustment and between-person variability was not reduced. Energy adjustment with either the energy density or residuals method did not alter the ranking of accuracy of various dietary assessment methods in comparison with weighed-food records or biochemical markers in either the total group of subjects or those who were identified as having provided valid weighed-food records.

Jejunal nutrition.

Contrary to the past experience of forced parenteral nutrition nowaday's the enteral [jejunal] nutrition enjoys priority. It is not questionable, that well adjusted and controlled application of fluid, ion, fat, carbon hydrate, amino acid promoted convalescence. The experiences of the Authors supports that enteral nutrition through technically proper outperformed jejunostomy does not increase complication rate and beside well controlled food administration provides the physiologic stimules of food, the method is relatively easy and cost effective. For this reason the Authors initiated jejunostomy at the end of larger interventions such as Akyama procedure, total gastrectomy, multivisceral interventions, pancreatectomy, operations for massive gastrointestinal bleeding and finally reoperations with extreme negative N-balance and with the chance of inability of oral feeding for several days.